Left ventricular opacification in dobutamine stress echocardiography

Transvenous echo contrast agent is administered for left ventricular opacification (LVO) to improve diagnostic yield of dobutamine stress echocardiography (DSE). We prospectively compared the test accuracy of DSE with, and without LVO in 58 high risk patients, for inducible wall motion abnormalities (WMA), in two groups. (Group A) had DSE plus LVO in intermediate dose (ID-DSE/LVO) and (Group B) had high dose (HD-DSE) without LVO. Coronary angiography was done in all positive patients, and disease severity graded. We determined test accuracy in all three coronary arterial (LAD; RCA and LCX) territories. Accuracy of WMA in (A) vs. (B) was: 88% vs. 75% in LAD; 81% vs. 75% in RCA and 87% vs. 44% in LCX territories respectively. We conclude that in high-risk subjects, test accuracy of ID-DSE/LVO is superior to plain HD-DSE.